Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB RYAN ELLINGSON, MSPT, SCS, ATC, CSCS
ActiveJACOB RYAN ELLINGSON, MSPT, SCS, ATC, CSCS is a Environmental Modification (OT) healthcare provider located in MORA, Minnesota. NPI 1346210432 is currently active in the NPPES registry. Verify at CMS.
Environmental Modification (OT) · MORA, MN
Registration Details
- NPI Number
- 1346210432
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 23, 2006 (20.566464373996 yrs)
- Last Updated
- Jul 9, 2014
- License
-
6749 (MN)
Practice Information
- Address
-
301 HIGHWAY 65 SMORA, MN, 550511899Browse MN providers · Browse ZIP 55051
- Phone
- 3202253356
- Fax
- 3202253370
- Primary Specialty
-
Environmental Modification (OT)
2251S0007X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.